High-frequency oscillatory ventilation and adjunctive therapies: Inhaled nitric oxide and prone positioning

Fan, Eddy; Mehta, Sangeeta

doi:10.1097/01.ccm.0000155927.54034.34

Cited by 20 publications

(9 citation statements)

References 60 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although iNO is supposed to improve oxy-genation by reducing ventilation-perfusion mismatch at first, it will induce vasodilatation of poorly ventilated areas, increasing ventilation-perfusion mismatch 127 . Improved oxygenation is not associated with increased survival rate because the temporary improvement of oxygenation does not indicate improved lung function, reduction of lung injury, or resolution of the underlying cause of ARDS including coexisting multi-organ damage 128 .…”

Section: Resultsmentioning

confidence: 99%

Clinical Practice Guideline of Acute Respiratory Distress Syndrome

et al. 2016

View full text Add to dashboard Cite

There is no well-stated practical guideline for mechanically ventilated patients with or without acute respiratory distress syndrome (ARDS). We generate strong (1) and weak (2) grade of recommendations based on high (A), moderate (B) and low (C) grade in the quality of evidence. In patients with ARDS, we recommend low tidal volume ventilation (1A) and prone position if it is not contraindicated (1B) to reduce their mortality. However, we did not support high-frequency oscillatory ventilation (1B) and inhaled nitric oxide (1A) as a standard treatment. We also suggest high positive end-expiratory pressure (2B), extracorporeal membrane oxygenation as a rescue therapy (2C), and neuromuscular blockage for 48 hours after starting mechanical ventilation (2B). The application of recruitment maneuver may reduce mortality (2B), however, the use of systemic steroids cannot reduce mortality (2B). In mechanically ventilated patients, we recommend light sedation (1B) and low tidal volume even without ARDS (1B) and suggest lung protective ventilation strategy during the operation to lower the incidence of lung complications including ARDS (2B). Early tracheostomy in mechanically ventilated patients can be performed only in limited patients (2A). In conclusion, of 12 recommendations, nine were in the management of ARDS, and three for mechanically ventilated patients.

show abstract

Section: Resultsmentioning

confidence: 99%

Clinical Practice Guideline of Acute Respiratory Distress Syndrome

et al. 2016

View full text Add to dashboard Cite

show abstract

“…Since therapeutic alternatives are lacking and the underlying concepts sound reasonable, multimodal therapeutic approaches are commonly used for salvage therapy in patients with ARDS [ 19 ]. Apart from subsets of patients in other HFOV trails, the combined use of HFOV and prone positioning is described in one case report and was investigated systematically in a prospective randomized study including 39 medical patients [ 15 , 20 ].…”

Section: Discussionmentioning

confidence: 99%

High frequency oscillatory ventilation and prone positioning in a porcine model of lavage-induced acute lung injury

et al. 2006

View full text Add to dashboard Cite

show abstract

“…For example, preliminary data suggest that earlier institution of HFOV may portend a better prognosis 76 and that there may be synergistic benefits of combining different rescue modalities for ARDS patients with severe, life-threatening hypoxemia. 77,78 Although some protocols have been reported, 79 there is insufficient evidence to support the superiority of any particular approach to rescue therapy. Whenever possible, such patients should be considered for transfer to institutions with significant experience in ALI and ARDS management to allow further expert evaluation and treatment.…”

Section: Role For Rescue Therapymentioning

confidence: 99%